An Asian and Pacific Islander MEDTEP Research Center in Hawaii will contribute to the State's goal of health care for all of its citizens (nearly 100% now have health insurance) and the nation's goal of increasing the span of healthy life, reducing health disparities, and achieving access to preventive service for all Americans. This center shares with all MEDTEP programs the major objective of improving the practice of medicine and resultant care of patients by outcomes research, but with all efforts focused on Asians and Pacific Islanders. Specific aims include the establishment of a broad base of community support and capabilities with core staff and collaborators who have expertise in outcomes research, training, technical assistance, and dissemination. This group includes academicians (all schools in the University of Hawaii College of Health Sciences and Law School), community groups, health care providers, individuals of Asian and Pacific Island ethnicity, and policy makers (Hawaii legislature and U.S. Congress). The design of all research projects will focus on outcomes. It is of considerable importance that provisions have been made for active participation of minority individuals of both sexes in the selection, design and methods used in all research projects. Provisions will also be made, as far as possible, for the minority members of the community health center staffs to receive on-the-job training and technical assistance in MEDTEP research. All projects will focus on outcomes research that will identify the most appropriate and effective treatment (including preventive measures) as viewed by providers, patients, policy makers, and payers. Confounding variables will be considered in research design including disease co-morbidity, skills of clinicians, resources, stage of disease and other factors. Comparative assessment of methods of treatment and prevention will be undertaken. Existing data banks including Medicare data, Department of Health statistics, hospital discharge data, and patient records may be used in research. Clinical guidelines will be communicated via all media including interactive video (Wennberg's video on management of B.P.H. has been reviewed by urologists, internists, and others here in Honolulu). Randomized clinical trials results may also be used and might be required to verify outcomes research uncertainties. These will be undertaken by organizations other than the MEDTEP Center.